The risk of unexplained antepartum stillbirth in second pregnancies following caesarean section in the first pregnancy

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Abstract
To determine if a previous caesarean section increases the risk of unexplained antepartum stillbirth in second pregnancies. Retrospective cohort study. Large Canadian perinatal database. 158 502 second births. Data were obtained from a large perinatal database, which supplied data on demographics, pregnancy complications, maternal medical conditions, previous caesarean section and pregnancy outcomes. Total and unexplained stillbirth. The antepartum stillbirth rate was 3.0/1000 in the previous caesarean section group compared with 2.7/1000 in the previous vaginal delivery group (P= 0.46). Multivariate logistic regression modelling, including terms for maternal age (polynomial), weight >91 kg, smoking during pregnancy, pre-pregnancy hypertension and diabetes, did not document an association between previous caesarean section and unexplained antepartum stillbirth (OR 1.27, 95% CI 0.92-1.77). Caesarean section in the first birth does not increase the risk of unexplained antepartum stillbirth in second pregnancies.